<%= render 'merchants/common/pagenav' %>
<div id="pageWrapper" class="merchant">
	<div id="pageBody">
<form accept-charset="UTF-8" action="/merchants/info_submit" class="new_merchant" id="new_merchant" method="post" enctype="multipart/form-data">
  <div class="input">
    <label for="merchant_address_line1">Line 1</label><br />
    <input id="merchant_address_line1" name="merchant_address[line1]" size="30" type="text" />
  </div>
  <div class="input">
    <label for="merchant_address_line2">Line 2</label><br />
    <input id="merchant_address_line2" name="merchant_address[line2]" size="30" type="text" />
  </div>
  <div class="input">
    <label for="merchant_address_city">City</label><br />
    <input id="merchant_address_city" name="merchant_address[city]" size="30" type="text" />
  </div>
  <div class="input">
    <label for="merchant_address_state">State</label><br />
    <input id="merchant_address_state" name="merchant_address[state]" size="30" type="text" />
  </div>
  <div class="input">
    <label for="merchant_address_country">Country</label><br />
    <input id="merchant_address_country" name="merchant_address[country]" size="30" type="text" />
  </div>
  <div class="input">
    <label for="merchant_address_phone">Phone</label><br />
    <input id="merchant_address_phone" name="merchant_phone[phone]" size="30" type="text" />
  </div>
  <div class="input">
    <label for="merchant_address_country">Business Info</label><br />
    <input id="merchant_info_business_info" name="merchant_info[business_info]" size="30" type="text" />
  </div>
  <div class="input">
    <label for="merchant_address_phone">Terms & Conditions</label><br />
    <input id="merchant_info_terms_and_conditions" name="merchant_info[terms_and_conditions]" size="30" type="text" />
  </div>
  <div class="input">
    <label for="merchant_info_shipping_info">Shipping Info</label><br />
    <input id="merchant_info_shipping_info" name="merchant_info[shipping_info]" size="30" type="text" />
  </div>
	<div class="input">
		<label>Image to be displayed</label>
		<input type="file" name="display_pic" id="display_pic" class="xLarge" />
	</div>
  <div class="actions">
    <input name="commit" type="submit" value="Submit" />
  </div>
</form>
</div>
</div>
